Abstract

Introduction

Electronic patient records are becoming more common in critical care. As their design
and implementation are optimized for single users rather than for groups, we aimed
to understand the differences in interaction between members of a multidisciplinary
team during ward rounds using an electronic, as opposed to paper, patient medical
record.

Methods

A qualitative study of morning ward rounds of an intensive care unit that triangulates
data from video-based interaction analysis, observation, and interviews.

Results

Our analysis demonstrates several difficulties the ward round team faced when interacting
with each other using the electronic record compared with the paper one. The physical
setup of the technology may impede the consultant's ability to lead the ward round
and may prevent other clinical staff from contributing to discussions.

Conclusions

We discuss technical and social solutions for minimizing the impact of introducing
an electronic patient record, emphasizing the need to balance both. We note that awareness
of the effects of technology can enable ward-round teams to adapt their formations
and information sources to facilitate multidisciplinary communication during the ward
round.